Spinal Anesthesia in the Hemophilia A Carrier Parturient

Hemophilia is a bleeding diathesis that inhibits proper hemostasis. The most common type of hemophilia is "Hemophilia A, or classic hemophilia," a condition manifested by a deficiency of factor VIII. Females may be carriers of the factor VIII gene deficiency increasing their risk of bleeding. Neuraxial anesthesia has been proven to be a safe procedure and provides adequate pain control while decreasing morbidity and mortality in the obstetric population. Case presented is a parturient scheduled for cesarean section of full-term twins that is a carrier of hemophilia A. This case represents the involvement of a multidisciplinary team including obstetrician, anesthetist, and hematologist identifying optimal treatment for this patient. The administration of recombinant factor VIII prior to neuraxial anesthesia provided replacement of deficient coagulation factor. With replacement factor supplied the patients plan of spinal anesthesia was performed without complications.